颅内静脉窦血栓形成的溶栓治疗比较研究

The thrombolytic treatment of cerebral venous sinus thrombosis: comparison between two methods

目的通过动脉、静脉窦途径注射尿激酶治疗上矢状窦(SSS)血栓形成,比较两种治疗的效果。方法清洁级青紫蓝大白兔48只,随机共分A、B、C三组,数目分别为24只、12只、12只,雌雄不限,体质量(2.36±0.27)kg。A组为对照组,B、C两组分别为经颈动脉、静脉窦注射尿激酶溶栓治疗组。第一步用临时夹闭加促凝法制作颅内静脉窦血栓形成(CVST)的动物模型,分别通过两种途径注射尿激酶治疗CVST,观察受累静脉窦血流速度、窦旁脑组织含水量、血流变等指标。结果经静脉窦途径治疗后脑组织含水量、基底静脉血流速度、血流变部分指标均与经动脉途径组比较有明显差异。结论直接静脉窦途径溶栓优于经颈动脉途径溶栓。

Objective To compare two thrombolytic treatments of cerebral venous sinus thrombosis.Methods Forty-eight New Zealand white rabbits,weighing 2.36 kg±0.27 kg,were divided into three groups,group A（n=24,control group）,group B（n=12,injected with urokinase via carotid artery for 5 d）,and group C（n=12,injected with urokinase via the superior sagittal sinus for 5 d）.Animal models of cerebral venous sinus thrombosis（CVST） were made by temporary clipping and promoting coagulation.And then thrombolytic treatment by urokinase injection via carotid artery and the superior sagittal sinus were performed to observe the blood velocity of involved venous sinus,para-sinus brain water content and hemorheological parameters.Results The brain water content of group C（via the superior sagittal sinus） was significantly lower than that of group B（via carotid artery） and control group（P0.05）.There was significant difference in the hemorheological parameters between group B and group C（P0.05）.Conclusion Thrombelysis via the superior sagittal sinus is better than via carotid artery.